DPP-4 inhibitor as add-on therapy in uncontrolled type 2 diabetes treated with multiple insulin injections

Abstract

Type 2 diabetes is a progressive disease and stepwise intensification of therapy is required to maintain good metabolic control. In the clinical practice recommendations of scientific societies intensive insulin therapy with multiple daily injections is the final stage of the treatment. In everyday clinical practice, however, we often encounter a situation where, despite such treatment, satisfactory glycemic control is not achieved. In this situation the question arises: whether the only therapeutic option is to systematically increase the dose of insulin? New anti-diabetic agents make it possible to find other solutions. The purpose of this paper is to present cases of patients in whom, instead of increasing the dose of insulin, a dipeptidyl peptidase-4 (DPP-4) inhibitor was added to the treatment. The observation lasting ≥ 6 months confirmed efficacy and safety of this strategy.